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Published on: December 11, 2017
Comparison of Early Outcomes Following Transjugular Transcatheter Tricuspid Valve Replacement Between Large vs Small
Fei Chen1, Xinyue Yang1, Fan Qiao2
1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, China; Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
Transcatheter tricuspid valve replacement (TTVR) outcomes vary by annular size. The small-annulus group showed better procedural success, but 30-day outcomes were similar, with specific adverse events differing between groups.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Transcatheter tricuspid valve replacement (TTVR) is an emerging treatment for severe tricuspid regurgitation (TR).
- Clinical outcomes of TTVR stratified by tricuspid annular size are not well-established.
- Understanding these differences is crucial for patient selection and procedural optimization.
Purpose of the Study:
- To evaluate and compare early clinical outcomes of transjugular TTVR using the LuX-Valve Plus device.
- To stratify outcomes based on patient annular size: large-annulus group (LAG) versus small-annulus group (SAG).
Main Methods:
- A prospective study enrolled 159 patients with grade ≥3 TR undergoing LuX-Valve Plus TTVR across 13 centers.
- Patients were categorized into LAG (annular diameter ≥51 mm or ≥55 mm) and SAG.
- Early outcomes assessed included device/procedural/intraprocedural success, TR reduction, and 30-day primary endpoints/clinical success.
Main Results:
- The SAG (n=117) demonstrated superior device/procedural success (97.4% vs 81.0%) and intraprocedural success (96.6% vs 78.6%) compared to the LAG (n=42).
- Thirty-day primary endpoint rates were similar between groups (14.5-22.2%).
- Severe paravalvular regurgitation occurred only in the LAG (7.1%), while new-onset third-degree AV block/pacemaker implantation was exclusive to the SAG (9.4%).
Conclusions:
- LuX-Valve Plus TTVR is safe and effective across different annular sizes.
- TR reduction was more significant in the SAG.
- Specific adverse event profiles differ between large and small annular sizes, warranting careful consideration.
